ITRACONAZOLE THERAPY IS EFFECTIVE FOR PEDAL ONYCHOMYCOSIS CAUSED BY SOME NONDERMATOPHYTE MOLDS AND IN MIXED INFECTION WITH DERMATOPHYTES AND MOLDS - A MULTICENTER STUDY WITH 36 PATIENTS

Background: Onychomycosis of the toenail caused by nondermatophyte mol ds alone or in combination with dermatophytes is difficult to eradicat e with standard antifungal therapy. Objective: Our purpose was to dete rmine the effectiveness of itraconazole in the treatment of toenail on ychomycosis caused by molds alone or in combination with dermatophytes . Methods: We treated 36 patients with this drug given as continuous d osing (100 or 200 mg/day) for 6 to 20 weeks or as a 1-week pulse dosin g (200 mg twice daily for 1 week per month) for two to four pulses. Re sults: Patients with toenail onychomycosis with the following organism s were treated: Aspergillus spp. (eight patients), Fusarium spp. (four patients), Scopulariopsis brevicaulis (23 patients), and Alternaria s pp. (one patient). Nineteen patients had onychomycosis with a mixed or igin. At follow-up, 12 months after therapy was initiated, clinical an d mycologic cure was achieved in 15 of 17 patients (88%) with onychomy cosis caused by a single mold. In patients with mixed infection, a cli nical cure was obtained in 16 of 19 patients (84%) and a mycologic cur e in 13 of 19 patients (68%). Conclusion: Itraconazole appears to be e ffective and safe for the treatment of toenail onychomycosis caused by some nondermatophyte molds alone or in combination with dermatophytes .